Provider Demographics
NPI:1477318830
Name:CERNY, NANCY (RDH)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:CERNY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:ADKIN-AKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:50 INDUSTRIAL PARK ROAD
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:MI
Mailing Address - Zip Code:49013
Mailing Address - Country:US
Mailing Address - Phone:269-427-7937
Mailing Address - Fax:269-427-5180
Practice Address - Street 1:308 CHARLES STREET
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:MI
Practice Address - Zip Code:49013
Practice Address - Country:US
Practice Address - Phone:855-869-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902011615124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist